The right thalamic ventral posterolateral nucleus seems to be determinant for macrosomatognosia: a case report
- PDF / 2,349,009 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 20 Downloads / 198 Views
CASE REPORT
Open Access
The right thalamic ventral posterolateral nucleus seems to be determinant for macrosomatognosia: a case report Amir H. ElTarhouni1, Laura Beer1, Michael Mouthon2, Britt Erni1, Jerome Aellen3, Jean-Marie Annoni2, Ettore Accolla2, Sebastian Dieguez2 and Joelle N. Chabwine1,2*
Abstract Background: Macrosomatognosiais the illusory sensation of a substantially enlarged body part. This disorder of the body schema, also called “Alice in wonderland syndrome” is still poorly understood and requires careful documentation and analysis of cases. The patient presented here is unique owing to his unusual macrosomatognosia phenomenology, but also given the unreported localization of his most significant lesion in the right thalamus that allowed consistent anatomo-clinical analysis. Case presentation: This 45-years old man presented mainly with long-lasting and quasi-delusional macrosomatognosia associated to sensory deficits, both involving the left upper-body, in the context of a right thalamic ischemic lesion most presumably located in the ventral posterolateral nucleus. Fine-grained probabilistic and deterministic tractography revealed the most eloquent targets of the lesion projections to be the ipsilateral precuneus, superior parietal lobule,but also the right primary somatosensory cortex and, to a lesser extent, the right primary motor cortex. Under stationary neurorehabilitation, the patient slowly improved his symptoms and could be discharged back home and, later on, partially return to work. Conclusion: We discuss deficient neural processing and integration of sensory inputs within the right ventral posterolateral nucleus lesion as possible mechanisms underlying macrosomatognosia in light of observed anatomoclinical correlations. On the other hand, difficulty to classify this unique constellation of Alice in wonderland syndrome calls for an alternative taxonomy of cognitive and psychic aspects of illusory body-size perceptions. Keywords: Macrosomatognosia, Alice in wonderland syndrome, Thalamus, Stroke, Ventral posterolateral nucleus, Diffusion tractography
* Correspondence: [email protected] 1 Division of Neurorehabilitation, Fribourg Hospital, Meyriez, Switzerland 2 Neurology Unit, Department of Neuroscience and Movement Science, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Chemin du Musée, 5, CH-1700 Fribourg, Switzerland Full list of author information is available at the end of the article
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is n
Data Loading...
